Sleep Apnea Wilmington DE

What is Sleep Apnea and how can it be treated?

Obstructive Sleep Apnea

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat. This blocks the upper airway and airflow stops. When the oxygen level in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears, and the flow of air starts again, usually with a loud gasp.

Repeated cycles of decreased oxygenation lead to very serious cardiovascular problems. Additionally, these individuals suffer from excessive daytime sleepiness, depression, and loss of concentration.

Some patients have obstructions that are less severe called Upper Airway Resistance Syndrome (UARS). In either case, the individuals suffer many of the same symptoms.

Sleep Apnea Treatment

The first step in treatment for sleep apnea resides in recognition of the symptoms and seeking appropriate consultation. Oral and maxillofacial surgeons offer consultation and treatment options.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region. With cephalometic (skull x-ray) analysis, the doctors can ascertain the level of obstruction. Sometimes a naso-pharyngeal exam is done with a flexible fiber-optic camera. To confirm the amount of cardiovascular compromise and decreased oxygenation levels, a sleep study may be recommended to monitor an individual overnight.

Treatment Options for Sleep Apnea

There are several treatment options available. An initial treatment may consist of using a nasal CPAP machine that delivers pressurized oxygen through a nasal mask to limit obstruction at night. One of the surgical options is an uvulo-palato-pharyngo-plasty (UPPP), which is performed in the back of the soft palate and throat. A similar procedure is sometimes done with the assistance of a laser and is called a laser assisted uvulo-palato-plasty (LAUPP). In other cases, a radio-frequency probe is utilized to tighten the soft palate. These procedures are usually performed under light IV sedation in the office.

In more complex cases, the bones of the upper and lower jaw may be repositioned to increase the size of the airway (orthognathic surgery). This procedure is done in the hospital under general anesthesia and requires a one to two day overnight stay in the hospital.

OSA is a very serious condition that needs careful attention and treatment. Most major medical plans offer coverage for diagnosis and treatment.

An oral appliance is a small acrylic device that fits over your upper and lower teeth (similar to an orthodontic retainer or mouth guard). This device slightly advances the lower jaw moving the base of the tongue forward to open the airway. This improves breathing and reduces or eliminates snoring and sleep apnea.

Oral Appliances

There are different types of oral appliances. Pre-fabricated non-custom oral appliances, tongue retaining devices and custom made mandibular advancement devices. Our practice provides custom-made mandibular advancement devices that are FDA-approved for the treatment of snoring and sleep apnea. Over the counter, pre-fabricated or “boil and bite” appliances are not recommended for the treatment of OSA.

In addition to a detailed history, the doctors will assess the anatomic relationships in the maxillofacial region.  The appliance is customized for each individual patient after taking impressions of your teeth and an X-ray or Scan.

Do I Need an Oral Appliance for Sleep Apnea?

According to the American Academy of Sleep Medicine, oral appliances are indicated for patients with snoring or mild to moderate obstructive sleep apnea who prefer oral appliances to Continuous Positive Airway Pressure (CPAP). Oral Appliance are also indicated for severe patients, who have difficulty tolerating, are non-compliant with or refuse CPAP.

Oral appliances are comfortable, easy to wear and most people find that it only takes a couple of weeks to become acclimated to wearing the appliance. These appliances are small, making them easy to carry when traveling.

Most insurance companies cover Oral Appliance therapy. Our office will collect all pertinent information required by insurance and work with them to ensure maximum coverage.

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